KANSAS NURSING HOMES: FAR TOO DEPENDENT ON MIND-ALTERING MEDS TO CONTROL PATIENTS

File under Ghastly.

Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.  

Then there is this: 

Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.

Like I said, ghastly. 

I don't know why adult children put their parents in nursing homes.  Why not use that same money to buy or rent an apartment.  That way the other tenants will involve him or her in their social life.  I mean if the complex is 10% ethical.  Most people are neutral.  Hopefully, there will be a 10% ethical influence among the tenants, which is enough to move things in the right direction.  Hopefully, people will do the neighborly thing.  As to regular meds, why rely on sedatives for your mom, dad, husband, or wife?  Don't you want your loved to thrive in all that he does? One neighbor I had was an older gentleman whose family lived back in Chicago.  He had emphasema but he still got around, drove around town, in fact, quite a bit with this portable oxygen tank.  Great guy.  But he left a pan with boiling water on the stove too long.  The water evaporated and the heat turned his pan into a conductor and smoke began filling his apartment house.  I smelled the smoke as it billowed out his window, so I stepped over to his apartment and knocked but his door was locked.  He was asleep and couldn't hear me knocking and pounding on his door or my screams of "Bob!"  I phoned the fire department and they broke into his kitchen window, woke him up, and extinguished the smoke.  I apologized for making a big to do about it, but he was grateful.  Somebody was looking out for him.

Red and brown onions, garlic, shallots, and leeks contain Benfotiamine.

Also, there are alternatives to dementia.  Ignore that information at your peril.  See at the bottom of this post for THE key ingredient to stave off dementia.  Understand that nutritional compounds, for them to work, require several weeks at resetting your biology, one that perhaps has been undernourished for years if not decades.  Too many folks expects miracles over night.  And still some vitamins actually do produce immediate miracles depending on your level of deficiency through diet, conditions, and lifestyle.  There is a lot to correct.  With Benfotiamine, you have to be on this B1 compound for 18 months for it to produce benefits.  Lots of folks will simply wax cynical, "Oh, yeah, of course, manufacturers [or nutritional reviewers] are going to say that so they can keep you on the product for months and years and profit from your desperation."  Not if it's noted up front.  If you didn't know that Benfotiamine requires 18 months to be effective, what would happen is that you would try it for a few weeks and give up, exclaiming "that stuff is not worth it."  Read that article.  It is the only effective B1 compound that protects nerves from dementia.  So there's that.

Leeks

For foods that contain Benfotiamine, you're already familiar with: onions, garlic, shallots, leeks, and other members of the allium family of vegetables.

In the interview seen here, Charlene Wagner explains that the St. John's nursing home was giving her husband, who was diagnosed with Lewy Body Dementia, sedatives Seroquel and Adol, saying that the nursing homes use these meds to sedate her husband, not cure, relieve, or heal her husband's condition.  Or, she says, "I would rather say that they use the meds to control them."  Yeah, that's about right.  Read what Seroquel is typically used for:

Seroquel is the brand name of the generic drug quetiapine, used to treat schizophrenia and bipolar disorder (formerly known as manic-depression).

Seroquel changes the levels of neurotransmitters (naturally occurring brain substances) including serotonin and dopamine.

Seroquel belongs to a class of medications called atypical antipsychotics.

Here is the article.

Kansas nursing homes have 'become far too dependent' on mind-altering meds.

  by Andy Marso and Kelsey Ryan.  

Allen Wagner used to light up when his granddaughter entered the room, but when she visits him at his nursing home in Overland Park now, he hardly reacts. He’s sleepy and uncommunicative.

He’s sedated.

Wagner, 78, has Lewy Body Dementia and Parkinson’s disease. But his wife, Charlene, said it’s hard to tell how much of his lethargy is due to that and how much is due to the anti-psychotic medications he was first given during an extended hospital stay and has continued taking in nursing homes.

“I’ve seen a change since he went to the nursing homes,” Charlene Wagner said. “Not because of the care. The care is good. I believe it’s the medicines.”

Anti-psychotics are contraindicated for people with dementia and include a U.S. Food and Drug Administration warning that they increase the risk of falls, stroke and other potentially fatal side effects.

The federal government started tracking the off-label use of such medications in nursing homes in 2011. Since then, Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.

“There’s something about that dementia coupled with the anti-psychotics,” said Margaret Farley, a board member for Kansas Advocates for Better Care, a group that represents nursing home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re robbing them of their personality, they won’t talk, they’re not active, etc, etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most of the time is related to cardiovascular changes or it’s related to the development of pneumonia.”

Kansas also led the nation last year in percentage of skilled nursing facilities cited by the federal government for a broad slate of medication-related violations, some of which relate to anti-psychotic use.

Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.

Now when people visit nursing homes they’ll no longer see residents strapped to beds and wheelchairs. But they will likely see some under “chemical restraint,” through the use of anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said have caused her husband to deteriorate.

Greenlee said she knows Kansas nursing homes are not the worst in the nation overall. But the rate at which they use anti-psychotics should cause some soul-searching about how they deal with difficult or disruptive behavior of residents with dementia.

“They can be overprescribed to sedate people and then mask the need to deal with these underlying causes (of disruptive behavior),” said Greenlee, who is now vice president of aging and health policy for the Center for Practical Bioethics in Kansas City, Mo.

Groups that represent Kansas nursing homes say the state’s anti-psychotic use ranking is unfairly skewed by a handful of homes that specialize in mental illness and that they face a number of challenges that are outside their control.

It’s hard to find enough qualified staff in many parts of the state. Some facilities rely heavily on Kansas Medicaid and payments under that program have been delayed for years due to bureaucratic changes. There’s also a shortage of psychiatrists in Kansas, especially those who specialize in treating older people.

“All of those I believe do factor into our ability to continue to really tackle this issue,” said Debra Zehr, the president and CEO of LeadingAge Kansas.

Cindy Luxem, the president and CEO of the Kansas Health Care Association, said Kansas homes have brought rates down, but they need help to reduce them further.

“We’re going to take a lot of responsibility on this topic, but at the same time we look at it as something where we really better start getting family members involved,” Luxem said. “Physicians, pharmacists, you name it.”

Zehr said that when doctors and nursing home workers use anti-psychotics on people who don’t have a mental illness, it’s not ideal, but it’s done with good intentions.

“Anybody who’s spent time with people in the throes of dementia and has seen the kind of internal anguish and volatile behaviors of people with dementia at certain stages, they’re trying to help,” Zehr said.

But some facilities have found better ways to handle those behaviors. Farley said more should follow their example.

“It’s not an easy thing to be able to take care of bad behaviors without these medications, but we’ve become far too dependent upon them,” Farley said.

The fight over the rankings

On average, 20 percent of all Kansas long-term nursing home residents received an anti-psychotic medication at some point in 2016, tying it for the highest rate in the country with Oklahoma and Mississippi. The national average is 16 percent. Missouri ranked near the top at about 19 percent.

Kansas has dropped from a high of about 26 percent in 2011, but other states’ rates have fallen more since then.